Related Experiment Video
Updated: Sep 23, 2026
Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
Published on: April 3, 2026
Equivalent survival in targeted axillary dissection compared to axillary lymph node dissection in patients with node
Callie Hlavin1,2,3, Zainab Balogun4, Danielle R Lavage5
1Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. hlavinca@upmc.edu.
Background:
The role of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in node-positive breast cancer (N + BC) is evolving with opportunities to de-escalate surgery in those with complete axillary pathologic response. SLNB may lead to equivalent outcomes while avoiding the morbidity of axillary lymph node dissection (ALND).
Methods:
This is a retrospective analysis of patients with N + BC who received NAC and targeted axillary dissection (TAD) with or without ALND from 2014 to 2021. Patients were categorized according to pathology of the previously positive radioactive seed marked lymph node into complete pathologic response (dSLN-) and persistent disease (dSLN+). We assessed the impact of axillary surgery on recurrence, disease-free survival (DFS), and overall survival (OS).
Results:
We included 284 female patients with median follow-up of 36.3 months. 128 patients had dSLN-of which 13 (10.2%) had ALND and 115 (89.9%) had TAD. There were 156 dSLN+ patients: 107 (68.6%) ALND and 49 TAD. In both groups, TAD resulted in similar mortality (dSLN-: 15.4% vs. 8.9%, p=.309; dSLN+: 9.3% vs. 10.2%, p = 1.000), DFS (dSLN-:19.6 mos vs. 30.7 mos, p=.166; dSLN+: 30 mos vs. 37 mos, p=.650) and OS (dSLN-: 49.3 mos vs. 45.8 mos, p=.868; dSLN+: 36.4 months vs. 36.2 months, p=.982) compared to ALND.
Conclusion:
For patients with dSLN-, there was no difference in recurrence, mortality, DFS, or OS between ALND and TAD. While there was a higher frequency of recurrence in patients who had dSLN + and underwent ALND compared to TAD, there was no difference in DFS or OS.
Clinical Trials Number:
Not applicable.
